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DOSS ENTERPRISES EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NameDOSS ENTERPRISES EMPLOYEE BENEFIT PLAN
Plan identification number 501

DOSS ENTERPRISES EMPLOYEE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

DOSS ENTERPRISES, LLC has sponsored the creation of one or more 401k plans.

Company Name:DOSS ENTERPRISES, LLC
Employer identification number (EIN):010763371
NAIC Classification:211120
NAIC Description:Crude Petroleum Extraction

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DOSS ENTERPRISES EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-06-01CLINT HOLBERT2024-11-11
5012022-06-01CLINT HOLBERT2023-11-10
5012021-06-01AMANDA WOODY2022-10-11
5012020-06-01BLAKE HARDISON2021-09-07
5012019-06-01MARY BAKER2020-08-21
5012019-06-01MARY BAKER2020-08-21
5012018-06-01AMBER GORE2019-11-12
5012017-06-01
5012016-06-01

Form 5500 Responses for DOSS ENTERPRISES EMPLOYEE BENEFIT PLAN

2023: DOSS ENTERPRISES EMPLOYEE BENEFIT PLAN 2023 form 5500 responses
2023-06-01Type of plan entitySingle employer plan
2023-06-01Plan funding arrangement – InsuranceYes
2023-06-01Plan funding arrangement – General assets of the sponsorYes
2023-06-01Plan benefit arrangement – InsuranceYes
2023-06-01Plan benefit arrangement – General assets of the sponsorYes
2022: DOSS ENTERPRISES EMPLOYEE BENEFIT PLAN 2022 form 5500 responses
2022-06-01Type of plan entitySingle employer plan
2022-06-01Plan funding arrangement – InsuranceYes
2022-06-01Plan benefit arrangement – InsuranceYes
2021: DOSS ENTERPRISES EMPLOYEE BENEFIT PLAN 2021 form 5500 responses
2021-06-01Type of plan entitySingle employer plan
2021-06-01Plan funding arrangement – InsuranceYes
2021-06-01Plan benefit arrangement – InsuranceYes
2020: DOSS ENTERPRISES EMPLOYEE BENEFIT PLAN 2020 form 5500 responses
2020-06-01Type of plan entitySingle employer plan
2020-06-01Plan funding arrangement – InsuranceYes
2020-06-01Plan benefit arrangement – InsuranceYes
2019: DOSS ENTERPRISES EMPLOYEE BENEFIT PLAN 2019 form 5500 responses
2019-06-01Type of plan entitySingle employer plan
2019-06-01Plan funding arrangement – InsuranceYes
2019-06-01Plan benefit arrangement – InsuranceYes
2018: DOSS ENTERPRISES EMPLOYEE BENEFIT PLAN 2018 form 5500 responses
2018-06-01Type of plan entitySingle employer plan
2018-06-01Plan funding arrangement – InsuranceYes
2018-06-01Plan benefit arrangement – InsuranceYes
2017: DOSS ENTERPRISES EMPLOYEE BENEFIT PLAN 2017 form 5500 responses
2017-06-01Type of plan entitySingle employer plan
2017-06-01Plan funding arrangement – InsuranceYes
2017-06-01Plan benefit arrangement – InsuranceYes
2016: DOSS ENTERPRISES EMPLOYEE BENEFIT PLAN 2016 form 5500 responses
2016-06-01Type of plan entitySingle employer plan
2016-06-01First time form 5500 has been submittedYes
2016-06-01Submission has been amendedNo
2016-06-01This submission is the final filingNo
2016-06-01This return/report is a short plan year return/report (less than 12 months)No
2016-06-01Plan is a collectively bargained planNo
2016-06-01Plan funding arrangement – InsuranceYes
2016-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BCPC
Policy instance 1
Insurance contract or identification numberGLUG0BCPC
Number of Individuals Covered181
Insurance policy start date2023-06-01
Insurance policy end date2024-05-31
Total amount of commissions paid to insurance brokerUSD $12,533
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $90,692
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00650280
Policy instance 2
Insurance contract or identification number00650280
Number of Individuals Covered117
Insurance policy start date2023-06-01
Insurance policy end date2024-05-31
Total amount of commissions paid to insurance brokerUSD $12,036
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedCRITICAL ILLNESS, ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $103,215
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
HIGHMARK WEST VIRGINIA (National Association of Insurance Commissioners NAIC id number: 54828 )
Policy contract number262872
Policy instance 1
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number262872
Policy instance 1
HIGHMARK WEST VIRGINIA (National Association of Insurance Commissioners NAIC id number: 54828 )
Policy contract number262872
Policy instance 1
HIGHMARK WEST VIRGINIA (National Association of Insurance Commissioners NAIC id number: 54828 )
Policy contract number262872
Policy instance 1
HEALTH PLAN UPPER OHIO VALLEY (National Association of Insurance Commissioners NAIC id number: 95677 )
Policy contract number125807601
Policy instance 1
HEALTH PLAN UPPER OHIO VALLEY (National Association of Insurance Commissioners NAIC id number: 95677 )
Policy contract number125807601 ET AL
Policy instance 1

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